Caring for Aging Parents and Loved Ones
January 23, 2023/
| According to AARP and National Alliance for Caregiving statistics, nearly 17% of American adults provide care for someone over the age of 50. Caring for an aging loved one is an emotional and sometimes all-consuming responsibility. The switch from child to caregiver can occur overnight and many adult children are not prepared. You may wonder if your parent is safe living in their own home, or if it is time to make other arrangements for their continued safety and well-being. Experts advise the best approach to evaluating a senior’ situation is a holistic one, considering the person’s overall health, but warn of a few tale-tale signs that your parent may be struggling. As the child of an aging parent, you should know how to recognize signs of trouble and develop a plan. Common signs of mental and physical decline include forgetfulness and memory lapses, noticeable weight loss or gain, mobility issues and frequent falls, difficulty with daily tasks and neglect of personal hygiene, becoming defensive and paranoid and social isolation and withdrawal. Unlike other places in the world, in the US, it is uncommon for the elderly to live in extended family situations, with most aging seniors living alone or with a similarly aged spouse or partner. Many families are not in a position to bring these individuals into their homes and provide 24/7 supervision. Alternative solutions include private in-home caregiving and assisted living or skilled nursing facilities commonly referred to as nursing homes. If you decide to move your elderly parent into your own home, it’s important to have a thorough understanding of the care they may require. Before making this decision, you should discuss options with your loved one’s doctor or other health care professional and ask yourself if you will be able to manage their chronic illnesses and physical limitations safely and effectively. While making this very important decision, you should consider your needs and schedule, be proactive and realistic, and know your limits. Additional considerations should include the number of individuals in your home to provide help, the number of individuals in your home who also depend on you for care, i.e., children and pets, and if you work, who will care for your loved one in your absence. The status and health of your relationship with your aging parent should also be considered. Will all parties be capable of living under one roof harmoniously? Will your home need modifications to provide for the necessities of your parent? If your parent is experiencing cognitive decline, it is likely that they will at some point become agitated or aggressive and will be at an increased risk for wandering, becoming lost and falling. The following are common dementia behaviors and suggestions for how to best handle them. Confusion – becomes more common as dementia progresses. Memory loss can lead to confusion, and this often manifests as repetitive questions, not recognizing formerly familiar people or places or disorientation. Factors contributing to disorientation may include: Sundown Syndrome – experienced by two-thirds of dementia patients, exhibits evening behavioral shifts characterized by increased memory loss, agitation, confusion and anger. The concept of Sundowners is similar to “morning sickness” in that symptoms may not always occur at sundown, but rather during the “witching hour,” typically in the late evening when the elderly individual may suddenly and completely change. Unexpected Changes – moving into a new place or changes in routine may negatively affect your loved one and add to their disorientation. Paranoia/Hallucinations – dementia results in complex changes in the brain, often resulting in delusions. May seniors see things, develop false beliefs and in some cases become suspicious of caregivers and loved ones. Tips for Managing Confusion – experts suggested that simplification is key to minimizing confusion. The following may be effective for you: Keep familiar objects around to help reorient your loved one. Add labels to drawers and cabinets, this is especially helpful when confusion about where to find things is a common trigger. Implement the use of tools such as alarms, calendars and to-do lists to help your loved one remember important tasks, such as taking medication, eating meals and performing personal hygiene. Use simple, short sentences when communicating and ask yes/no questions. Normalize their experiences, approaching confusion with the attitude of “You’re confused. It’s okay. We’ll figure it out together.” Lead conversations with what you feel may be causing your loved one distress, such as “It seems like you’re looking for something, can I help you.” Examples of yes-no questions include “Are you looking for your keys,” “Are you looking for your glasses,” etc. You should work to accept your loved one’s confusion; the delusions they experience are their reality. Remember to be patient and that if their beliefs are not harming anyone, it’s better to play along as opposed to correcting which often leads to agitation and aggression. Aggression – verbal threats and physical aggression are among the more serious dementia behaviors with verbal and physical outbursts occurring from seemingly out of nowhere. Aggression symptoms typically come to a head in the latter stages of dementia once your loved one is no longer capable of communicating their wants and needs. Unfortunately, caregiver abuse is a common occurrence, but it is important for you to remember your loved one does not do these things intentionally and to find ways to redirect their behavior. The following are common causes of aggression in dementia patients: Confusion – feeling disoriented and scared, may lead to acting out with aggression. Physical pain or other unmet need – being unable to verbalize or address basic needs such as hunger, thirst or pain. Emotional pain – your loved one may feel lonely, depressed or isolated. Discomfort from a specific task – some aging adults may show aggression during particular times such as bath time, bedtime or when performing other important daily tasks such as getting dressed or eating meals which are particularly stressful. Medication side effects – changes in medications and difficulties with medication management may interfere with dementia, leading to aggression. Vision and hearing loss – can compound the typical disorientation of dementia, causing seniors to act out in confusion and out of fear. Sundown syndrome – daily aggression occurs around sunset. Fear – inability to recognize caregivers, doctors and others may alert your loved one’s fight or flight response, resulting in aggression. Tips for Managing Aggression in Seniors Reassure – let your loved one know that you are there for them and that everything is okay. Reorient – use a familiar object to reorient your loved one to their environment. Redirect – your loved one’s attention with a familiar object or something that brings them joy during times of aggressive behavior. Reminisce – advert your loved one’s aggression through reminiscing about a particularly joyful time or event. Sleep Problems – sleep quality tends to decline with age, but individuals with dementia are prone to more sleep disturbances than average seniors, affecting as many as one-third of those diagnosed with dementia. Common sleep problems may include: Difficulty or inability to fall or stay asleep; Agitation and restlessness at times designated for sleep; Disorientation to day/night. Common causes of sleep disturbances in individuals with dementia include: Brain changes – steeper changes in sleep architecture and circadian rhythms. OTC Medications – some over-the-counter medications labeled for nighttime use may result in sleep disturbances by making individuals with dementia sleepy at the wrong time. Diet – excess caffeine, sugar and alcohol can result in sleep disturbances. Electronics – blue light from electronic screens may delay and disturb sleep patterns. Tips for Managing Dementia Sleep Problems Limit your loved one’s intake of caffeine, alcohol and sugar, especially close to bedtime. Avoid over-the-counter sleep aids and nighttime NSAIDs. Discuss other options with your loved one’s physician. Remove electronic devices from your loved one’s sleeping quarters. Create routines to support sleep such as making sure your loved one is exposed to enough daytime light to help with circadian rhythms, change into designated comfortable sleeping clothes, and consider warm milk, a hot shower, reading or relaxing music. Pick a reasonable bedtime and stick to it. Wandering – wandering in demented adults can be dangerous and, in some instances, deadly. Sixty percent of those with dementia wander and are known to leave a confusing situation or try to find someone and become disoriented and lost. Caregivers often feel guilt associated with the use of protective measures, but these precautions are extremely important if you plan to house your aging parent in your own home. Tips for Managing Wandering in Loved Ones with Dementia Secure all doors, paying special attention to doors leading to the outside or steps. Use technology to monitor your loved one such as a tracking device or baby monitor. Make all people in your life and surrounding your loved one aware of their potential to wander. Enlist as much help as you can. As a caregiver, it is also important to remember your health as well to avoid caregiver burnout. If your loved one becomes too much to care for in your home, there are other options available. Caregiver support groups and counselors can help you navigate the array of emotions that come along with caring for an aging parent. If you reach the realization that you cannot provide or can no longer provide adequate care to your elderly loved one, you should consider skilled nursing facilities or assisted living communities, depending on their specific needs. Many skilled nursing facilities offer long and short-term care for seniors with chronic illnesses, severe cognitive impairment, and terminal diseases. Most assisted living communities offer increased security, support and social activities. Do Diligent Research When Selecting a Nursing Home or Skilled Nursing Facility When selecting a long-term care facility for your loved one, doing your research is paramount. This is a big decision and shouldn’t be made in a rush. You should examine government records and conduct facility visits. There are a number of challenges faced by today’s nursing homes that may directly affect the care your loved one receives. These challenges include staffing problems, worsened by COVID-19, and infection control. An April 2022 report by the National Academies of Sciences, Engineering and Medicine called for nationwide improvement of nursing home quality. According to the committee chair, Betty Ferrell, “The way in which the United States finances, delivers and regulates care in nursing home settings is ineffective, inefficient, fragmented and unsustainable.” Medicare provides an online tool that allows you to compare nursing homes, hospitals and other care facilities in your area which uses a five-star ranking system based on quality measures, vaccination rates and inspection reports. You can find this resource by visiting https://www.medicare.gov/care-compare/. Other resources include Nursing Home Inspect and NursingHome411. You should always visit potential facilities, talk with administration and staff and observe how residents are cared for. Look at how the residents are groomed and how long they wait for help from facility staff and check out food menus, activity schedules and other amenities. Do not choose a facility based solely on its physical appearance or higher prices. More expensive, does not always mean better. It is always a good idea to have your loved one close to home, but if an adequate facility is not available, broaden your search. Payment Options for Skilled Nursing and Long-Term Care Facilities In 2022 the national average for nursing home costs were about $8000.00 per month for a semi-private room and $9,300.00 for a private room. Prices are further dependent on care and health needs, type of room and location. Missouri and Kansas are on the cheaper side when compared to other states with the following average costs in 2022: Private Room Monthly Cost Semi-Private Room Monthly Costs Missouri $6,109.00 $5,420.00 Kansas $7,017.00 $6,485.00 Payment options for nursing home residency include long-term care insurance, private health insurance, and Medicaid (if qualified). Medicare does not cover long-term residency in a nursing home but may cover some costs for short-term stays under specific, limited circumstances. In these cases, Medicare may pay a portion of costs up to 100 days in skilled a nursing facility, but your loved one must have received at least three consecutive days of inpatient hospital treatment and must be admitted to the facility within 30 days of being discharged from the hospital. Additionally, the skilled nursing must be for the same injury or illness as the initial hospitalization. Hospital social workers can help you find adequate placement for your loved one under these circumstances. Nursing Home Neglect and Abuse in Kansas City Statistically, 1 in 10 older Americans are abused annually, but only 1 in 23 instances of elder abuse is reported. For this reason, if you are the child of an aging parent in Kansas City, you need to be aware of the warning signs of nursing home abuse and neglect. For more information on how to recognize the signs, download our informative pamphlet, What You Need to Know About Nursing Home Abuse & Neglect. If you feel your aging parent or loved one has suffered abuse or neglect in a Kansas City nursing home, we understand that you are rightfully enraged. Kendall Law Group LLC has been helping individuals and families throughout Kansas and Missouri for decades and our dedicated team has developed specialized knowledge and expertise in nursing home neglect and elder abuse. If you feel your loved one has been victimized by a nursing home, you need a skilled trial team on your side. Kendall Law Group is here to help you seek justice. Contact us at (816) 531-3100 or sign up HERE for a free consultation. |
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